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Lacunar Stroke Treatment - Oren Zarif - Lacunar


The first step in treating lacunar stroke is to evaluate the patient. Doctors may order a CT scan and magnetic resonance imaging (MRI) tests to identify the cause of the stroke. The purpose of the CT scan is to rule out other conditions that can cause similar symptoms. MRI is a better way to diagnose a lacunar stroke. MRIs are particularly sensitive at identifying very new cases of lacunar stroke. In severe cases, a doctor may order both tests to rule out other causes.

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Other risk factors for lacunar stroke include age, high blood pressure, smoking, diabetes mellitus, and elevated cholesterol levels. Prior strokes may increase a person's risk. People with chronic high blood pressure or heart problems are also at risk. Black people are at increased risk for developing lacunar infarct. Two studies on the incidence of lacunar strokes conducted in communities with predominantly Black populations showed that black patients had a higher incidence of the condition than white patients.

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While lacunes may be caused by emboli from the heart or larger arteries, there is no way to tell whether a specific infarct on an MRI would explain the symptoms. A higher percentage of lacunes may be silent. However, a CT/MRI may be helpful in excluding other conditions. The treatment of lacunar stroke is the same as that of ischemic stroke. It requires matching clinical features to an infarct of a small noncortical area.

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In contrast to strokes of the cortex of the brain, lacunar infarcts of the deeper brain structures (basal ganglia) are not associated with complaints of subjective memory. Nevertheless, they are not uncommon. It is vital to note that the recovery from stroke is not the same for all patients. Often, strokes do not have any long-term consequences, but they may be a warning sign for patients.

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Microhaemorrhages are a potential risk factor for intracerebral haemorrhage. The presence of microhaemorrhages increases the risk of stroke during antithrombotic therapy. Further, studies of microhaemorrhages in patients with lacunar stroke need detailed patient classification to determine if they are caused by emboli. The use of MRI and other imaging techniques to assess the underlying mechanisms of lacunar ischaemic stroke may lead to the development of diagnostic and prognostic markers.

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Although a lacunar infarct can cause temporary impairment of some functions of the brain, it is a very common and treatable type of stroke. Early treatment can reduce the severity of symptoms and save the patient's life. In severe cases, however, the brain may be completely damaged and may require physical rehabilitation. In severe cases, the patient may require physical rehabilitation for several months or even years. If left untreated, a lacunar stroke can lead to permanent disability.

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Although very few patients die from lacunar stroke, it can occur long after the initial symptoms. As such, the autopsy material is often scanty and the brain is difficult to dissect, making diagnosis difficult. The Oxfordshire Community Stroke Project Classification has defined lacunar stroke as an entity with poor overall functional outcome. Although the diagnosis remains controversial, this research is a significant step towards achieving a definitive understanding of this condition.

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Another form of stroke is a lacunar infarct. It occurs when the blood flow to a deeper part of the brain is blocked. These are small arteries that branch directly from the large main artery. High blood pressure directly damages these arteries, which are heavily muscled. This pressure can also cause the formation of fatty deposits. The damage to these arteries may be permanent and even disabling. Many lacunar infarcts are completely asymptomatic.

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Patients with lacunar ischemic infarctions should be monitored closely by a neurologist, physical therapist, occupational therapist, and social therapist. Physical therapy is often used to correct physical deficits, while muscle relaxants are used to relieve spasticity and help patients regain physical function. Continuing rehabilitation therapy is essential for optimal neurologic function. A patient's primary care provider is responsible for long-term care coordination. Treatment must include intensive antihypertensive therapy and aggressive treatment of lipid levels.

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